Provider Demographics
NPI:1578288924
Name:GOLDEN MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:GOLDEN MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAHMO
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:KASSIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-930-9201
Mailing Address - Street 1:2413 SYCAMORE DR APT 5
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-5146
Mailing Address - Country:US
Mailing Address - Phone:920-930-9201
Mailing Address - Fax:
Practice Address - Street 1:1740 E MASON ST # 5
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54302-3258
Practice Address - Country:US
Practice Address - Phone:920-930-9201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)